• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.10 no.1
• /
• pp.51-59
• /
• 2007

Purpose: Recently well-developed anorectal function tests have revealed that there is an obvious pelvic floor dyssynergia (PFD) pattern in pediatric patients with constipation, as well as in adult's. The use of biofeedback therapy (BT) has been widely implemented in adult PFD patients; however, this approach has only rarely been considered for pediatric PFD patients. Therefore, we assessed the effectiveness of BT in children with PFD. Methods: We studied 70 children with PFD, who were referred to the department of pediatrics at the Asan Medical Center for the management of soiling or chronic constipation from September 2002 to February 2005. Diagnosis of PFD and assessment of the efficacy of BT for PFD treatment were carried out along with several ano-rectal function tests (cine-defecography, ano-rectal manometry, balloon expulsion test and intra-anal EMG); in addition, a questionnaire was administered. The BT based intra-anal EMG was performed. A follow-up telephone interview was performed more than 6 months later. Results: Most of the symptoms and results of the ano-rectal function tests were statistically improved after BT. In comparisons between the BT and control groups (BT refusal group due to poor compliance), the symptoms were statistically improved at follow-up. Therefore, for the shortterm improvement of symptoms, BT was better than conservative therapy alone. The negative feelings associated with ano-rectal function testing and BT were directly associated with failure or success of therapy. Conclusion: Pediatric patients with constipation or soiling that presented with an obvious PFD pattern showed that BT was a useful therapeutic tool for rapid improvement of symptoms.

• Journal of Preventive Medicine and Public Health
• /
• v.33 no.2
• /
• pp.208-214
• /
• 2000

Objectives : Face-to-face interviews were conducted to investigate the relationship between blood pressure and the impairment of cognitive function in rural elderly (N=932) aged 60-64 in Dalsung County, April to September in 1996 Methods : Impairment of cognitive function was defined as a score of less than 23 by the Korean version of the Mini-Mental State Examination (MMSEK). Blood pressure was measured once in each subject using a portable automatic sphygmomanometer. Results : By univariate logistic regression on males, no category of systolic blood pressure bore statistical significance. Groups with diastolic blood pressures of, less than 80 mmHg, 90-94 mmHg, and more than 95mmHg had odds ratios of more than one compared with the reference group (80-89 mmHg). This was most significant in the group with blood pressures lower than 80 mmHg, which had a statistically significant odds ratio of 1.68 (95% confidence interval CI; 1.02-2.75). No category of blood pressure was statistically significant in females. Multivariate logistic regression for males, with adjustment for age, educational attainment, smoking, alcoholic drinking, body mass index, atherosclerotic disease, and antihypertensive medication use, did not alter the odds ratios significantly in terms of systolic blood pressure. However, the group with diastolic blood pressure of less than 80 mmHg had an increased odds ratio of 2.01 (95% CI; 1.15-3.52) compared with the reference group. In females, systolic blood pressure did not alter the odds ratio, but the group with a diastolic blood pressure of less than 80 mmHg had a statistically significant odds ratio of 0.57 (95% CI; 0.37-0.89). Conclusions : These results suggest that the relationship between blood pressure and cognitive function status is stronger diastolic than systolic blood pressure and that there is a complex relationship between blood pressure and cognitive function by sex.

• Childhood Kidney Diseases
• /
• v.14 no.2
• /
• pp.203-209
• /
• 2010

Purpose : It has been a common medical practice to use prophylactic antibiotics to prevent recurrent urinary tract infections (UTI) in high risk situations such as urinary tract obstruction, vesicoureteral reflux, neurogenic bladder, or urinary stones. But sometimes, we meet difficult situation of breakthrough infections (BI) which might cause new or progressive renal scarring. The clinical characteristics of children contracting breakthrough UTI experienced in a single center were studied. Methods : The study was done retrospectively through medical records of 150 pediatric patients who had been cared in pediatric and urologic clinics of Pusan National University Hospital from Jan. 2001 till June 2006 and had prophylactic antibiotics to prevent recurrent UTI. Results : The starting age of prophylactic antibiotics of 150 patient was 1-76 months, and median age was 5 months. The BI developed 61 times in 43 patients (28.7%), 1.5 times per 100 patient-months. The BI occurred more frequently in patients with higher grade of VUR, and in the cases with abnormal DMSA scan. Co-trimoxazole was more effective than 2nd and 3rd generation cephalosporins to prevent UTI. The distribution of causative organisms was more diverse than usual UTI. The causative organisms were sensitive to the antibiotics used for prophylaxis in 29.5%, and resistant in 59.1%. After experience of BI, 40 percents of patients went to the surgical treatment including endoscopic injection of Deflux, 35% to new antibiotics for prophylaxis, 26% remain on the same antibiotics as the previous one. Conclusion : Based on our study results, preexisting renal scar might be one of the factors which should be considered in favor of early surgical interventions of VUR. Poor compliance and wrong selection of antibiotics such as cephalosporins are important underlying causes of breakthrough UTIs.

• Journal of radiological science and technology
• /
• v.38 no.4
• /
• pp.365-374
• /
• 2015

The regular quality assurance (RQA) of X-ray images is essential for maintaining a high accuracy of diagnosis. This study was to evaluate the modulation transfer function (MTF), the noise power spectrum (NPS), and the detective quantum efficiency (DQE) of a computed radiography (CR) system for various periods of use from 2006 to 2015. We measured the pre-sampling MTF using the edge method and RQA 5 based on commission standard international electro-technical commission (IEC). The spatial frequencies corresponding to the 50% MTF for the CR systems in 2006, 2009, 2012 and 2015 were 1.54, 1.14, 1.12, and $1.38mm^{-1}$, respectively and the10% MTF for 2006, 2009, 2012, and 2015 were 2.68, 2.44, 2.44, and $2.46mm^{-1}$, respectively. In the NPS results, the CR systems showed the best noise distribution in 2006, and with the quality of distributions in the order of 2015, 2009, and 2012. At peak DQE and DQE at $1mm^{-1}$, the CR systems showed the best efficiency in 2006, and showed better efficiency in order of 2015, 2009, and 2012. Because the eraser lamp in the CR systems was replaced, the image quality in 2015 was superior to those in 2009 and 2012. This study can be incorporated into used in clinical QA requiring performance and evaluation of the performance of the CR systems.

• Journal of Chest Surgery
• /
• v.39 no.11 s.268
• /
• pp.815-821
• /
• 2006

Background: Carotid endarterectomy is an effective treatment modality in patients with severe carotid artery stenosis, but it may result in serious postoperative complications, We analyzed the results of the carotid endarterectomy performed in our institution to reduce the complications related to the card endarterectomy. Material and Method: We analyzed retrospectively the medical records of 74 patients(76 cases) who underwent carotid endarterectomy for carotid artery stenosis by a single surgeon from February 1996 to July 2004. Result: There were 64 men and 10 women. The mean age of the patients was 63.6 years old. Carotid endarterectomy only was performed in 63 cases, carotid endarterectomy with patch angioplasty in 8 cases, and carotid endarterectomy with segmental resection of internal carotid artery and end to end anastomosis in 5 cases. Intra-arterial shunt was used in 29 cases. The mean back pressures of internal carotid arteries checked after clamping common carotid arteries and external carotid arteries were $23.48{\pm}10.04$ mmHg in 25 cases with changes in electroencephalography(group A) and $47.16{\pm}16.04$ mmHg in 51 cases without changes in electroencephalography(group B). There was no statistical difference in the mean back pressure of internal carotid arteries between two groups(p=0.095), but the back pressures of internal carotid arteries of all patients with changes in electroencephalography were under 40 mmHg. When there was no ischemic change of electroencephalography after clamping common carotid artery and external carotid artery, we did not make use of intra-arterial shunt regardless of the back pressure of internal carotid artery. Operative complications were transient hypoglossal nerve palsy in four cases, cerebral hemorrhage occurred at previous cerebral infarction site in two cases, mild cerebral infarction in one case, hematoma due to anastomosis site bleeding in one case, and upper airway obstruction due to laryngeal edema probably caused by excessive retraction during operation in two cases. One patient expired due to cerebral hemorrhage occurring at previous cerebral infarction site. Conclusion: Carotid endarterectomy is a safe operative procedure showing low operative mortality. We suggest that intra-arterial shunt usage should be decided according to the ischemic change of electroercephalography regardless of the back pressure of internal carotid artery. Excessive retraction during operation should be avoided to prevent upper alway obstruction due to laryngeal edema and if upper airway obstruction is suspected, prompt management is essential.

• Journal of Biomedical Engineering Research
• /
• v.25 no.5
• /
• pp.391-401
• /
• 2004

3D imaging systems using 2D phased arrays have a large number of active channels, compelling to use a very expensive and bulky beamforming hardware, and suffer from low volume rate because, in principle, at least one ultrasound transmit-receive event is necessary to construct each scanline. A high speed 3D imaging method using a cross array proposed previously to solve the above limitations can implement fast scanning and dynamic focusing in the lateral direction but suffer from low resolution except at the fixed transmit focusing along the elevational direction. To overcome these limitations, we propose a new real-time volumetric imaging method using a cross array based on the synthetic aperture technique. In the proposed method, ultrasound wave is transmitted successively using each elements of an 1D transmit array transducer, one at a time, which is placed along the elevational direction and for each firing, the returning pulse echoes are received using all elements of an 1D receive array transducer placed along the lateral direction. On receive, by employing the conventional dynamic focusing and synthetic aperture method along lateral and elevational directions, respectively, ultrasound waves can be focused effectively at all imaging points. In addition, in the proposed method, a volume of interest consisting of any required number of slice images, can be constructed with the same number of transmit-receive steps as the total number of transmit array elements. Computer simulation results show that the proposed method can provide the same and greatly improved resolutions in the lateral and elevational directions, respectively, compared with the 3D imaging method using a cross array based on the conventional fixed focusing. In the accompanying paper, we will also propose a new real-time 3D imaging method using a cross array for improving transmit power and elevational spatial resolution, which uses linear wave fronts on transmit.

• Progress in Medical Physics
• /
• v.13 no.4
• /
• pp.209-217
• /
• 2002

There have been many studies on the application of the reciprocal advantages of multimodality image to define accurate target volume in the Process of radiation treatment planning. For the proper use of the multimodality images, the registration works between different modality images should be performed in advance. In this study, we selected chamfer matching method and mutual information method as most popular methods in recent image registration studies considering the registration accuracy and clinical practicality. And the two registration methods were analyzed to deduce the optimal registration method according to the characteristics of images. Lung phantom of which multimodality images could be acquired was fabricated and CT, MRI and SPECT images of the phantom were used in this study. We developed the registration program which can perform the two registration methods properly and analyzed the registration results which were produced by the developed program in many different images' conditions. Although the overall accuracy of the registration in both chamfer matching method and mutual information method was acceptable, the registration errors in SPECT images which had lower resolution and in degraded images of which data were removed in some part were increased when chamfer matching method was applied. Especially in the case of degraded reference image, chamfer matching methods produce relatively large errors compared with mutual information method. Mutual information method can be estimated as more robust registration method than chamfer matching method in this study because it did not need the prerequisite works, the extraction of accurate contour points, and it produced more accurate registration results consistently regardless of the images' characteristics. The analysis of the registration methods in this study can be expected to provide useful information to the utilization of multimodality images in delineating target volume for radiation treatment planning and in many other clinical applications.

• Sleep Medicine and Psychophysiology
• /
• v.11 no.1
• /
• pp.29-36
• /
• 2004

Objectives: Sound and light (SL) stimulation has been used as a method to induce some useful mental states in the fields of psychology and psychiatry. It is believed that sound and light entrainment device (SLED) has some specific effects through synchronization of EEG in patients who use it. Theta frequency is believed to stimulate deep relaxation and short term memory processing. This study was conducted to evaluate if 4-10 Hz SL stimulation can induce relaxation and improve short term memory function. Methods: Ten medical students with no medical or psychiatric problems participated in this study. Subjects were randomly divided into two groups. One group was applied with real SLED was applied to one group (R group) and pseudo SLED to the other group (P group). The two groups were exposed to SL stimulation with SLED 15 minutes a day for 5 days, and after two days rest the two groups were switched over. The Korean Wechsler Adult Intelligence Scale (K-WAIS), Academic Motivation Tests (AMT), Test Anxiety Scale (TAS), Korean Auditory Verbal Learning Test (K-AVLT), and digit span were used to evaluate short term memory. Spielberger's State-Trait anxiety inventory and heart rate variability (HRV) test were used to evaluate degree of relaxation. Results: Compared with S group, R group showed a significant improvement in K-AVLT and digit span after a single application of SL stimulation. But 5-day long application did not reveal any differences between the two groups. A significant change in HRV was observed in 5-day long application of SL stimulation after being switched over to other SLED. Conclusion: This pilot study suggests that 4-10 Hz SL stimulation has some positive influences on short term memory and relaxation.

• Progress in Medical Physics
• /
• v.9 no.2
• /
• pp.65-71
• /
• 1998

The aims are to evaluate the effects of an 1.0 cm acrylic plate and SSD on the dose profile and depth dose distribution of 9 MeV electron beam and to analyse adequacy for using an acrylic plate to reduce energy of electron beams. An acrylic plate of 1.0 cm thickness was used to reduce energy of 9 MeV electron beam to 7 MeV. The plate was put on an electron applicator at 65.4 cm distance from x-ray target. The size of the applicator was 10${\times}$l0cm at 100 cm SSD. For 100cm, l05cm and 110cm SSD, depth dose on beam axis and dose profiles at d$\_$max/ on two principal axes were measured using a 3D water phantom. From depth dose distributions, d$\_$max/, d$\_$85/, d$\_$50/ and R$\_$p/, surface dose, and mean energy and peak energy at surface were compared. From dose profiles flatness, penumbra width and actual field size were compared. For comparison, 9 MeV electron beams were measured. Surface dose of 7 MeV electron beams was changed from 85.5% to 82.2% increasing SSD from 100 cm to 110 cm, and except for dose buildup region, depth dose distributions were independent of SSD. Flatness of 7 MeV ranged from 4.7% to 10.4% increasing SSD, comparing 1.4% to 3.5% for 9 MeV. Penumbra width of 7 MeV ranged from 1.52 cm to 3.03 cm, comparing 1.14 cm to 1.63 cm for 9 MeV. Actual field size increased from 10.75 cm to 12.85 cm with SSD, comparing 10.32 cm to 11.46 cm for 9 MeV. Virtual SSD's of 7 and 9 MeV were respectively 49.8 cm and 88.5cm. In using energy reducer in electron therapy, depth dose distribution were independent of SSD except for buildup region as well as open field. In case of using energy reducer, increasing SSD made flatness to deteriorate more severely, penumbra width more wide, field size to increase more rapidly and virtual SSD more short comparing with original electron beam. In conclusion, it is desirable to use no energy reducer for electron beam, especially for long SSD.

• Korean Journal of Korean Medical Institute of Dermatology and Aesthetics
• /
• v.1 no.1
• /
• pp.127-144
• /
• 2005

This study compared the activity of the aerial part of P. japonicum with its root in order to examine the possibility of the medicinal use of the aerial part, which has not been used as medicine, in substitute for the root that has traditionally been used as medicine. For this purpose, the author measured the proliferation of Human $CD4^-$ T cells, which are related to immunity, the differentiation of HL-60 cells, and the contents of IL-6, IgE and $TNF-{\alpha}$ and compared their anti-cancer effect on Hep3B and A549 cells. The results of this study are as follows: 1. As for Human $CD4^-$ T cells, $1.0\;g/{\ell}$ methanol extract from the aerial part promoted the proliferation of the cells 1.8 times higher while $1.0\;g/{\ell}$ methanol extract from the root did by 1.76 times higher compared to the control group. 2. As for HL-60 cells, methanol extract and water extract from the aerial part showed differentiation 1.14 times higher and 1.12 times higher respectively while methanol extract and water extract from the root did 1.14 times higher and 1.07 times higher compared to tile control group. 3. Cell density was highest on Day 4 of culture in all samples, Methanol extracts from the aerial part and the root showed activities of $7.9{\times}10^3\;cells/m{\ell}$ and $7.5{\times}10^3\;cells/m{\ell}$ respectively, and water extracts from the aerial part and the root did activities of $5.3{\times}10^3\;cells/m{\ell}$ and $6.1{\times}10^3\;cells/m{\ell}$. 4. The secretion of IL-6 was highest on Day 4 of culture. Methanol extracts from the aerial part and the root showed secretions of $6.7{\times}10^{-3}\;pg/cells/m{\ell}$ and $7.2{\times}10^{-3}\;pg/cells/m{\ell}$ respectively, and water extracts from the aerial part and the root did secretions of as high as $7.0{\times}10^{-3}\;pg/cells/m{\ell}$ and $6.0{\times}10^{-3}\;pg/cells/m{\ell}$. 5. As for the production of IgE, water extract from the root effectively inhibited the product at $1,000\;{\mu}g/m{\ell}$, methanol extract from the root at $10\;{\mu}g/m{\ell}$ and $100\;{\mu}g/m{\ell}$, water extract from the aerial at $1,000\;{\mu}g/m{\ell}$, and methanol extract from the aerial part at $1,000\;{\mu}g/m{\ell}$. 6. According to the result of measuring the content of $TNF-{\alpha}$, methanol extracts from the root and the aerial part showed inhibition effect at $10\;{\mu}g/m{\ell}$, $100\;{\mu}g/m{\ell}$ and $1,000\;{\mu}g/m{\ell}$. 7. As for liver cancer cell Hep3B, $1.0\;g/{\ell}$ methanol extracts from the root and the aerial part showed inhibition effects of 78% and 70% respectively, and $1.0\;g/{\ell}$ water extracts from the root and the aerial part did inhibition effects of 56% and 59%. 8. As for lung cancer cell A549, $1.0\;g/{\ell}$ methanol extracts from the root and the aerial part showed inhibition effects of 75% and 70% respectively, and $1.0\;g/{\ell}$ water extracts from the root and the aerial part did inhibition effects of 48% and 45%. The results of this study presented above show that the aerial part of P. japonicum has immunizing and anti-cancer effects as high as its root, which has commonly been used as medicine. There should be more in-depth research on the aerial part of P. japonicum in the future.